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PERMIT APPLICATION <br /> BUlLDING / MEC�-IANICAL/PLUMBINC I SlGN 1 SPRINKLER/ DEMC?L.ITION <br /> Ct'TY OF EVER�7T PERMIT SERV[CE5 <br /> 32RU CEC}AR STREET,EVGRE7T.iNA J82Q1 <br /> (P)4F5-257-8810 J FA�4�5a�5T�8F357 �{�}�v�;retteps�'weverettvu�.go�r( wvow.c;verettw�.gr�vfp�r�ot� <br /> Bl�e or��ck Inlc C�ntyr'PI+���� PR�i►.1Et:T�1"���t�i�'O1�MATit'fN <br /> 'PROJECfi SITE ADDRESS: ` c� . � e , Pi2t7PERTY TAX#:��� '� �C�C�� ��o�C�(� <br /> L�GAI.for ne+N constrGiciion: Short PlaU'subdivis�on __....__ _TLat No. l�ttach wpy ot tong legai de�sc:nption) <br /> �NTAC'�'IIYIFQRM/1Ttfllrl <br /> C71N[JER NAME: •� � �(' TENAN7 NAME{if Commercial)� ! �i�"� �"—"" <br /> OWNER MAILING ADDRESS: srrieer ��c�.� L (->� � ,� <br /> � j <br /> CI7v �`< <br /> STA �, Z� �� , <br /> OWNER PHONE: � '� `"'7�.;� 1 � } �� OWNER EMAlL: C; (�L � � �� �j �;�.� s C� <br /> CONTRACTORNAME: ' +���j� " }�G' •.�—' �} <br /> CONTRACTOR AODRE55: srr�eeT <br /> �'�T� STATE Z�' <br /> Ct}NTRACTOR PNONE: CC?NTI2AC1`t3R EMAIL <br /> CC►idTRACTpFt LtCENSE#(RFQUIREb): CI7Y Ofi EVERETT BUSINESS UCEN5E#(itECtUtREC)}: <br /> . _. _ _ . __ __........ <br /> PRIMARY CONTACT: UWNER ❑Ci.INTRACTOR C�C�TNER(Pie�se Specrfy} <br /> COtdl"ACT NAME� t�� , i�^��� i m� CU1+17ACT PkfC3NE: <br /> � Y � 1 l <br /> C+C)AITACT EMAiI. <br /> �1�Nt�i PERIYIIT APPLIGAT1f,�� <br /> 9 9' ��a4.� 1"�"��`� �� �£.`��`�.'�" °�` � �s��C:�. �at? <br /> Existin llse of Buildin a t nee of Work:$ � <br /> Proposed Use of Buildin : ♦� Heat So�rce: L7Gas Electric OOther <br /> Building Type: C�SFR-t�etached C35�R-Altached ❑Duplex ❑Mutti-Family-#of Units: ommercial ❑Industriai <br /> T pe of Project: ❑New �Addition ❑Rernade) ❑Re air ❑T.L DSign C�Sprinkler ODemolition ❑Chan e of Use <br /> DESCRIPTION O�W4RK: y <br /> ,_,� �U.l.-��-"l C �71 �t��t�...� �` (.��..-t�1��-Q �-� �l�...-t�1� (.� <br /> �,,,�,�����.�� �,� �� �� . <br /> ASSOCIATEO BUILDING PERMIT#(if a licablel: <br /> MECHANlCAL PERMIT APPtlCATION; PI.UM�ING P�RMIT APP�.fCAT1+t3N <br /> Type of Project: �New �_ Addn �Aiteratian Repair 7ype of F'rojact: New Addn Aiteratic�n Repair <br /> ff turos List of Fixtures F�ictures �-�y=°f Ffxtur�s #�# Lrst of F/xtures #pf tlst af Fixtures <br /> Fixtures Fixhtres <br /> �i/C—Air Handlin Units Heat Pti�m�s Tailet BackflQw Preverttar lflside 81d <br /> Farced Air S stems Unit Flea#er �athfub lJrknat <br /> Gas Pi in Boiler �avako Wash B�sin Urinkin Faunfain <br /> V+/ater Hea#�r Refn eration Shc�w�r FttiQr Drairt <br /> Gas Fire ace Woad Skov� Kitch�n Sink&t7is osal Gr��Se Tra <br /> Gas R�n e C3unfiirr Dishwash�r Roc�f pr�irt� � <br /> Clothes C� €rr Haoicups Qther: C;tothrt�s Washer Meci(cai Gas <br /> Ran e Noad W�ter Meater Uiher: <br /> Ex aust Fan $ink SerriceB�rlMoplatc. Uther. <br /> SPRINKLER!SURPt'tLS810N iiYSTEiII <br /> Chemical or Water Nr�.of Heads <br /> AGKNOWLEt?GEMEIVT:I have raviewsd this applJcation a1�d confirm tha rnformat+on containec�herein is true and comect. Work d�ne pursuant to this wennit mus#comply wtth <br /> current lec(eral,s(ate,and ioceJ/aw.Tne grent�ng ot A perrnit nniy autharrzes approued wor�and r7a devlat�ons thdrefrom.DeNsL'ons must lirst be suthorized r�wHtrny from tfre <br /> �uitdrny UNicial befr,re being authorized under eny crrcumsiance.!am!he owner,or i am authorized by the owner of this properiy to perform the work tor which apptication;s mede, <br /> and 1 compty with the State Contrector L,�w•18.27 h'CW and 296.20UA WAC. <br /> Ciry of Everelt t�fficiat Use Dnly <br /> .,,y"�,�.--�.-�-.�.--� PERMIT# ,�> <br /> ��,j�-..�...�C....,.�a � �� (` r �3 � i; �`� <br /> , <br /> OwnerfAuthorized Agent Signature Qete (Revrsed 9J23/2016j <br /> �'�-�....� '�-�t.��' Y'� � ~� �''�r'"`�, t ! t^�`�.t _ i� '�...'�.,. <br />